Liječnički vjesnik, Vol. 136 No. 1-2, 2014.
Review article
FROM UNEXPLAINED FEVER TO VISCERAL LEISHMANIASIS – A CASE REPORT
Ivan Marković
Ana Gudelj-Gračanin
Melanie-Ivana Čulo
Tajana Štoos-Veić
Ninoslava Vicković
Boško Desnica
Jadranka Morović-Vergles
Abstract
Visceral leishmaniasis or kala-azar is a systemic infectious vector-borne disease caused by protozoa Leishmania donovani and Leishmania infantum that are transmitted to mammalian hosts by sand flies. It occurrs sporadically in endemic areas, including Mediterranean basin. Southern coastal territories of Croatia have been recognized as the foci of the disease. Dogs are the main reservoir of human infection. Clinical features include prolonged fever, malaise, hepatosplenomegaly, pancytopenia and inversion of albumin-globulin ratio. If left untreated, the disease causes death in majority of cases. We report a 47-year-old Croatian patient who was admitted to hospital with 2-month history of fever of unknown origin. Based on bone marrow aspirate findings and positive serological tests, the diagnosis of visceral leishmaniasis was established. We also considered secondary hemophagocytic lymphohystiocytosis in the differential diagnosis. After a 4-week treatment with sodium-stibogluconate clinical remission was achieved as well as complete recovery of hematopoesis. The aim of our case-report is to stress the importance of considering visceral leishmaniasis in patients with long-standing fever in endemic areas.
Keywords
Leishmaniasis, visceral – diagnosis, drug therapy; Antimony sodium gluconate – therapeutic use; Antiprotozoal agents – therapeutic use; Leishmania – isolation and purification; Fever of unknown origin – parasitology
Hrčak ID:
172579
URI
Publication date:
27.2.2014.
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